Individual
BRIAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
907 E BRIGGS AVE, FAIRFIELD, IA 52556-3007
(641) 469-4353
(641) 469-4288
Mailing address
907 E BRIGGS AVE, FAIRFIELD, IA 52556-3007
(641) 469-4353
(641) 469-4288
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02808
IA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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